Farmers’ markets have long been the darlings of the local food movement, but the bags of goods exchanging hands at some 7,000 locations nationwide represent less than 1 percent of total US agricultural production. Meanwhile, vast quantities of food crisscross the nation in the industrial food supply stream, quietly showing up, day after day, at the loading docks of the largest food buyers.

“Farmers’ markets are an important part of building local food systems,” says James Barham, an agricultural economist at the US Department of Agriculture, “but more fundamental change will come from connecting small and mid-sized local farmers with institutional purchasers that are expressing ever more demand for sustainable food.” Even small shifts in institutions’ purchasing can have major consequences. An average hospital food budget can run upwards of $4 million, while the healthcare sector as a whole commands $12 billion worth of food and beverage purchases annually.